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The Spanish lower extremity functional scale: A reliable, valid and responsive questionnaire to assess musculoskeletal disorders in the lower extremity

Abstract Purpose: The Lower Extremity Functional Scale (LEFS) is a widely used questionnaire to evaluate the functional impairment of a patient with a disorder of one or both lower extremities. It also can be used to monitor the patient over time and to evaluate the effectiveness of an intervention....

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Published in:Disability and rehabilitation 2014-11, Vol.36 (23), p.2005-2011
Main Authors: Cruz-Díaz, David, Lomas-Vega, Rafael, Osuna-Pérez, María Catalina, Hita-Contreras, Fidel, Fernández, Ángeles Díaz, Martínez-Amat, Antonio
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cited_by cdi_FETCH-LOGICAL-c418t-c4320cf1805489aac0c44f0ef3f26e7d312f93972a0008996bad71f48fa97d5f3
cites cdi_FETCH-LOGICAL-c418t-c4320cf1805489aac0c44f0ef3f26e7d312f93972a0008996bad71f48fa97d5f3
container_end_page 2011
container_issue 23
container_start_page 2005
container_title Disability and rehabilitation
container_volume 36
creator Cruz-Díaz, David
Lomas-Vega, Rafael
Osuna-Pérez, María Catalina
Hita-Contreras, Fidel
Fernández, Ángeles Díaz
Martínez-Amat, Antonio
description Abstract Purpose: The Lower Extremity Functional Scale (LEFS) is a widely used questionnaire to evaluate the functional impairment of a patient with a disorder of one or both lower extremities. It also can be used to monitor the patient over time and to evaluate the effectiveness of an intervention. Nevertheless there is no Spanish version of the LEFS, so the aim of this study was the translation and cross-cultural adaption of the Spanish version of the LEFS and to evaluate its psychometrics properties. Methods: The questionnaire was cross cultural adapted into Spanish. The psychometric properties tested in the Spanish version of the LEFS were: internal consistency, test-retest reliability, constructs validity, discriminative validity, responsiveness, concurrent validity and floor and ceiling effects in 132 participants seeking for treatment due to lower extremity dysfunction. Results: The Spanish version of the LEFS had high internal consistency (Cronbach's α = 0.989), test-retest reliability (ICC = 0.998, 95% CI: 0.996-0.999) and presented a high correlation with the SF-36 (36-Item Short-Form Health Survey) especially with the physical function and pain subscales. The construct validity showed a single factor that account for 84.95% of the variance. The standard error of measurement of the Spanish version of the LEFS was 0.88 scale points (95% CI) and the minimal detectable change was 2.18 scale points (95% CI). The sample, collected from five Spanish physical therapy centers, was divided in groups (acute, sub-acute and chronic subjects). Within group changes showed a significant improvement on the LEFS score (p 
doi_str_mv 10.3109/09638288.2014.890673
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It also can be used to monitor the patient over time and to evaluate the effectiveness of an intervention. Nevertheless there is no Spanish version of the LEFS, so the aim of this study was the translation and cross-cultural adaption of the Spanish version of the LEFS and to evaluate its psychometrics properties. Methods: The questionnaire was cross cultural adapted into Spanish. The psychometric properties tested in the Spanish version of the LEFS were: internal consistency, test-retest reliability, constructs validity, discriminative validity, responsiveness, concurrent validity and floor and ceiling effects in 132 participants seeking for treatment due to lower extremity dysfunction. Results: The Spanish version of the LEFS had high internal consistency (Cronbach's α = 0.989), test-retest reliability (ICC = 0.998, 95% CI: 0.996-0.999) and presented a high correlation with the SF-36 (36-Item Short-Form Health Survey) especially with the physical function and pain subscales. The construct validity showed a single factor that account for 84.95% of the variance. The standard error of measurement of the Spanish version of the LEFS was 0.88 scale points (95% CI) and the minimal detectable change was 2.18 scale points (95% CI). The sample, collected from five Spanish physical therapy centers, was divided in groups (acute, sub-acute and chronic subjects). Within group changes showed a significant improvement on the LEFS score (p &lt; 0.001) and effect sizes were large in all conditions. The LEFS allowed to distingue between acute and not acute conditions; for this criterion ROC curve was performed at baseline (area under the curve [AUC] = 0.95). There was no floor or ceiling effects. Conclusions: The Spanish version of the LEFS has been shown to be a valid and reliable tool to assess musculoskeletal dysfunction in the lower extremity that could be used with Spanish speaker population.Implications for RehabilitationCross-cultural adaptation of a self-reported questionnaire to evaluate musculoskeletal lower extremity disorders in the Spanish population.To provide Spanish clinicians and physiotherapists a useful tool to assess the lower extremity function.To provide Spanish researchers a valid tool for research on lower extremity function: patient's improvement due to treatment, compare results obtained between populations, treatment.</description><identifier>ISSN: 0963-8288</identifier><identifier>EISSN: 1464-5165</identifier><identifier>DOI: 10.3109/09638288.2014.890673</identifier><identifier>PMID: 24593163</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Adult ; Aged ; Cross-Cultural Comparison ; Cross-Sectional Studies ; Disability Evaluation ; Female ; Humans ; Lower Extremity - physiopathology ; Lower extremity functional scale ; Male ; Middle Aged ; Musculoskeletal Diseases - diagnosis ; Musculoskeletal Diseases - psychology ; Musculoskeletal Diseases - rehabilitation ; Psychometrics ; Recovery of Function ; reliability ; Reproducibility of Results ; ROC Curve ; Severity of Illness Index ; Spain ; Spanish version ; Surveys and Questionnaires ; Translations ; Treatment Outcome ; validity</subject><ispartof>Disability and rehabilitation, 2014-11, Vol.36 (23), p.2005-2011</ispartof><rights>2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-c4320cf1805489aac0c44f0ef3f26e7d312f93972a0008996bad71f48fa97d5f3</citedby><cites>FETCH-LOGICAL-c418t-c4320cf1805489aac0c44f0ef3f26e7d312f93972a0008996bad71f48fa97d5f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24593163$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cruz-Díaz, David</creatorcontrib><creatorcontrib>Lomas-Vega, Rafael</creatorcontrib><creatorcontrib>Osuna-Pérez, María Catalina</creatorcontrib><creatorcontrib>Hita-Contreras, Fidel</creatorcontrib><creatorcontrib>Fernández, Ángeles Díaz</creatorcontrib><creatorcontrib>Martínez-Amat, Antonio</creatorcontrib><title>The Spanish lower extremity functional scale: A reliable, valid and responsive questionnaire to assess musculoskeletal disorders in the lower extremity</title><title>Disability and rehabilitation</title><addtitle>Disabil Rehabil</addtitle><description>Abstract Purpose: The Lower Extremity Functional Scale (LEFS) is a widely used questionnaire to evaluate the functional impairment of a patient with a disorder of one or both lower extremities. It also can be used to monitor the patient over time and to evaluate the effectiveness of an intervention. Nevertheless there is no Spanish version of the LEFS, so the aim of this study was the translation and cross-cultural adaption of the Spanish version of the LEFS and to evaluate its psychometrics properties. Methods: The questionnaire was cross cultural adapted into Spanish. The psychometric properties tested in the Spanish version of the LEFS were: internal consistency, test-retest reliability, constructs validity, discriminative validity, responsiveness, concurrent validity and floor and ceiling effects in 132 participants seeking for treatment due to lower extremity dysfunction. Results: The Spanish version of the LEFS had high internal consistency (Cronbach's α = 0.989), test-retest reliability (ICC = 0.998, 95% CI: 0.996-0.999) and presented a high correlation with the SF-36 (36-Item Short-Form Health Survey) especially with the physical function and pain subscales. The construct validity showed a single factor that account for 84.95% of the variance. The standard error of measurement of the Spanish version of the LEFS was 0.88 scale points (95% CI) and the minimal detectable change was 2.18 scale points (95% CI). The sample, collected from five Spanish physical therapy centers, was divided in groups (acute, sub-acute and chronic subjects). Within group changes showed a significant improvement on the LEFS score (p &lt; 0.001) and effect sizes were large in all conditions. The LEFS allowed to distingue between acute and not acute conditions; for this criterion ROC curve was performed at baseline (area under the curve [AUC] = 0.95). There was no floor or ceiling effects. Conclusions: The Spanish version of the LEFS has been shown to be a valid and reliable tool to assess musculoskeletal dysfunction in the lower extremity that could be used with Spanish speaker population.Implications for RehabilitationCross-cultural adaptation of a self-reported questionnaire to evaluate musculoskeletal lower extremity disorders in the Spanish population.To provide Spanish clinicians and physiotherapists a useful tool to assess the lower extremity function.To provide Spanish researchers a valid tool for research on lower extremity function: patient's improvement due to treatment, compare results obtained between populations, treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Cross-Cultural Comparison</subject><subject>Cross-Sectional Studies</subject><subject>Disability Evaluation</subject><subject>Female</subject><subject>Humans</subject><subject>Lower Extremity - physiopathology</subject><subject>Lower extremity functional scale</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Musculoskeletal Diseases - diagnosis</subject><subject>Musculoskeletal Diseases - psychology</subject><subject>Musculoskeletal Diseases - rehabilitation</subject><subject>Psychometrics</subject><subject>Recovery of Function</subject><subject>reliability</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Spain</subject><subject>Spanish version</subject><subject>Surveys and Questionnaires</subject><subject>Translations</subject><subject>Treatment Outcome</subject><subject>validity</subject><issn>0963-8288</issn><issn>1464-5165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp9kU1rFDEYx4Modq1-A5EcPbhrMsm8xINSim9Q8GA9h2czT9jUTLLmmWndT-LXdcZtBT30kkD4v4UfY8-l2CgpzGthGtVVXbephNSbzoimVQ_YSupGr2vZ1A_ZapGsF80Je0J0JYSQqtWP2Umla6Nko1bs1-UO-dc9pEA7HvMNFo4_x4JDGA_cT8mNISeInBxEfMPPeMEYYBvxFb-GGHoOqZ_faJ8ThWvkPyakxZIgFORj5kCERHyYyE0x03eMOM55faBceizEQ-LjvOG_7qfskYdI-Oz2PmXfPry_PP-0vvjy8fP52cXaadmN86kq4bzsRK07A-CE09oL9MpXDba9kpU3yrQVzJ_vjGm20LfS686Dafvaq1P28pi7L_nPdjsEchgjJMwTWdlUrWhrqetZqo9SVzJRQW_3JQxQDlYKuyCxd0jsgsQekcy2F7cN03bA_q_pjsEseHcUhORzGeAml9jbEQ4xF18guUBL_L0Vb_9J2CHEceegoL3KU5n50f0bfwNSw7Iu</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Cruz-Díaz, David</creator><creator>Lomas-Vega, Rafael</creator><creator>Osuna-Pérez, María Catalina</creator><creator>Hita-Contreras, Fidel</creator><creator>Fernández, Ángeles Díaz</creator><creator>Martínez-Amat, Antonio</creator><general>Informa UK Ltd</general><general>Taylor &amp; 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It also can be used to monitor the patient over time and to evaluate the effectiveness of an intervention. Nevertheless there is no Spanish version of the LEFS, so the aim of this study was the translation and cross-cultural adaption of the Spanish version of the LEFS and to evaluate its psychometrics properties. Methods: The questionnaire was cross cultural adapted into Spanish. The psychometric properties tested in the Spanish version of the LEFS were: internal consistency, test-retest reliability, constructs validity, discriminative validity, responsiveness, concurrent validity and floor and ceiling effects in 132 participants seeking for treatment due to lower extremity dysfunction. Results: The Spanish version of the LEFS had high internal consistency (Cronbach's α = 0.989), test-retest reliability (ICC = 0.998, 95% CI: 0.996-0.999) and presented a high correlation with the SF-36 (36-Item Short-Form Health Survey) especially with the physical function and pain subscales. The construct validity showed a single factor that account for 84.95% of the variance. The standard error of measurement of the Spanish version of the LEFS was 0.88 scale points (95% CI) and the minimal detectable change was 2.18 scale points (95% CI). The sample, collected from five Spanish physical therapy centers, was divided in groups (acute, sub-acute and chronic subjects). Within group changes showed a significant improvement on the LEFS score (p &lt; 0.001) and effect sizes were large in all conditions. The LEFS allowed to distingue between acute and not acute conditions; for this criterion ROC curve was performed at baseline (area under the curve [AUC] = 0.95). There was no floor or ceiling effects. 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identifier ISSN: 0963-8288
ispartof Disability and rehabilitation, 2014-11, Vol.36 (23), p.2005-2011
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language eng
recordid cdi_informahealthcare_journals_10_3109_09638288_2014_890673
source Taylor and Francis:Jisc Collections:Taylor and Francis Read and Publish Agreement 2024-2025:Medical Collection (Reading list)
subjects Adult
Aged
Cross-Cultural Comparison
Cross-Sectional Studies
Disability Evaluation
Female
Humans
Lower Extremity - physiopathology
Lower extremity functional scale
Male
Middle Aged
Musculoskeletal Diseases - diagnosis
Musculoskeletal Diseases - psychology
Musculoskeletal Diseases - rehabilitation
Psychometrics
Recovery of Function
reliability
Reproducibility of Results
ROC Curve
Severity of Illness Index
Spain
Spanish version
Surveys and Questionnaires
Translations
Treatment Outcome
validity
title The Spanish lower extremity functional scale: A reliable, valid and responsive questionnaire to assess musculoskeletal disorders in the lower extremity
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